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PA Health Policy Update for Friday, September 2

The following is an update of selected state health policy developments in Pennsylvania for the week of August 29-September 2, 2022.  (Some of the language used below is taken directly from state documents.)

Revenue Collection Update

The Department of Revenue has released its monthly revenue update for August.  General Fund revenue collection exceeded estimate by $63.8 million, or 2.3 percent, for the month.  Fiscal year-to-date General Fund collections total $5.6 billion, which is $60.4 million, or 1.1 percent, above estimate.

Department of Human Services

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin to notify providers of updates to the Medical Assistance fee schedule for adult vaccines.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to expand the scope of eligible providers that may render certain services to include psychiatric outpatient clinics, outpatient drug and alcohol clinics, and physicians and to add behavioral health providers to certain procedure codes and make other procedure code changes.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to announce changes to the Medical Assistance fee schedule, including changes resulting from the implementation of the 2022 Healthcare Common Procedure Coding System (HCPCS) procedure codes updates.  In addition, it also is adding other procedure codes and making changes to procedure codes currently on the Medical Assistance fee schedule, including setting limitations and prior authorization requirements.  These changes are effective for dates of service on and after August 29, 2022.  Find the bulletin here.
  • DHS has published a Medical Assistance Bulletin to inform Federally Qualified Health Centers and Rural Health Clinics of updates to the Medical Assistance fee schedule for the distribution of take-home supplies of nasal or injectable naloxone to Medicaid
    beneficiaries.  Find the bulletin here.
  • DHS has published brief notices addressing extra recoupments it has returned to some providers and provider enrollment summary enhancements.
  • DHS has posted federal financial participation rate changes and continued billing requirements for community support service providers.  Find the notice here.
  • DHS has posted HealthChoices enrollment and Medical Assistance Transportation Program utilization data for July.  Find the information here.

Department of Health

  • The Department of Health (DOH) has updated its “Innovative Hospital Model” guidance to make requested changes about locations eligible to operate outpatient emergency departments.  Find that updated information here.
  • DOH has revised its guidance for contacting the Division of Acute and Ambulatory Care prior to an event or change that requires advance notification, such as addition of new equipment or occupancy.  The updated guidance includes email subjects that providers should use when sending these notices to expedite review by the Division of Acute and Ambulatory Care.  Find the updated guidance here.
  • DOH’s annual Pennsylvania Long Term Care Questionnaire is now open until Friday, October 28.  Providers that have not received an email containing login information and instructions should contact Thomas Gavrish at tgavrish@pa.gov.
  • DOH will offer free potassium iodide, or KI, tablets on Thursday, September 15 to Pennsylvanians who are within 10 miles of the state’s four active nuclear power plants as part of routine preventive efforts in case of future emergencies.  Learn more from this department news release.

COVID-19:  By the Numbers

Monkeypox

  • DHS has published a Medical Assistance Bulletin to advise providers of the addition of procedure codes to use when billing for diagnostic laboratory testing for the orthopoxvirus and for the administration of the monkeypox vaccines.  Find the bulletin here.
  • The CDC has posted an updated map showing the distribution of 19,465 confirmed cases of monkeypox in the U.S. as of September 1, up from 16,926 cases on August 25.  561 of those cases were in Pennsylvania, up from 465 a week ago.
  • As of August 29, 327 of those Pennsylvania monkeypox cases were in Philadelphia, up from 257 a week ago.  Learn more about monkeypox in Philadelphia from the city Department of Public Health’s digital monkeypox dashboard.

Stakeholder Events

Department of Human Services – Mental and Behavioral Health Considerations for Long-Term Care – September 8

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on mental and behavioral health considerations for long-term care on Thursday, September 8 at 2:00.  This presentation will explore the most common behavioral health diagnoses seen among residents living in nursing facilities and will share approaches to managing appropriate use of psychotropic medication and best practices around deprescribing.  Learn more about the event and how to participate from this notice.

Pennsylvania Health Care Cost Containment Council – September 8

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet virtually on Thursday, September 8 at 10:00.  Agendas will be available here 24 hours.  The public is invited to participate. Contact rgreenawalt@phc4.org at least 24 hours in advance for participation instructions.

Patient Safety Authority – September 8

The Patient Safety Authority will meet virtually on Thursday, September 22 at 1:00.  For information about how to participate, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee Consumer Subcommittee – September 21

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, September 21 at 1:00.  Go here to register to participate.

DHS – Medical Assistance Advisory Committee – September 22

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, September 22 at 10:00.  Go here to register to participate.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30.  The meeting location will depend on COVID-19 mitigation efforts at that time.  If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg.  If the meeting is held virtually it will be held at bit.ly/ABC_MAP.  To dial in, call 267-332-8737, conference ID 440 338 696#.  Learn more from this Pennsylvania Bulletin notice.

 

2022-09-02T18:45:52+00:00September 2nd, 2022|COVID-19, HealthChoices, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, September 2

PA Health Policy Update for Friday, July 15

The following is an update of selected state health policy developments in Pennsylvania for the week of July 11-15, 2022.  (Some of the language used below is taken directly from state documents.)

Final FY 2023 Budget

Governor Wolf signed the Fiscal Code (House Bill 1421) into law on Monday, July 11. With the Fiscal Code’s signing, all the relevant budget-related bills for FY 2023 are enacted, including the budget bill (Senate Bill 1100) and the Tax Code (House Bill 1342).

Governor Wolf

Governor Wolf has signed several bills addressing health care issues.

  • House Bill 1421 increases Medicaid rates for skilled nursing facilities to help them meet upcoming Department of Health regulation updates that in part will increase staffing requirements.  The rate increase of nearly 20 percent increases Medicaid funding for skilled nursing care by almost $300 million a year.
  • House Bill 2097 amends Title 35 (Health and Safety), in emergency medical services system, further providing for basic life support ambulances.
  • House Bill 2419 amends the Outpatient Psychiatric Oversight Act by adding a definition of “telebehavioral health technology” and provisions regarding the use of the technology.
  • House Bill 2604 amends the employee photo identification provisions of the Health Care Facilities Act.
  • House Bill 2679 amends the Pharmacy Act to preserve three regulatory suspensions authorized under the COVID-19 disaster emergency declaration, including the ability of pharmacists to provide influenza and COVID-19 vaccines to children ages five and older.
  • Senate Bill 818 amends the Health Care Facilities Act for the purpose of allowing ambulatory surgical facilities to seek an exception or waiver from the Department of Health for certain surgical procedures and permits cardiac catheterization to be performed in ambulatory surgical facilities.
  • Senate Bill 1235 amends the Insurance Company Law, further providing for contracts and coverage packages in comprehensive health care for uninsured children.
  • House Bill 2032 amends the Sexual Assault Testing and Evidence Collection Act, providing that the failure to report injuries by firearm or criminal act does not constitute an offense if the submission of sexual assault evidence is an anonymous submission.

General Assembly

The state House and Senate are currently in recess. The House is scheduled to return to session on Monday, September 12 and the Senate is scheduled to return on Monday, September 19.

Department of Human Services

COVID-19:  By the Numbers

  • The daily average of newly reported COVID-19 cases rose 17 percent over the past week, to 2850 new cases a day.
  • COVID-19-related deaths in the past week remained comparable to their level of recent weeks.
  • The number of Pennsylvanians hospitalized with COVID-19 and on ventilators because of the virus remained generally steady over the past week but the number in hospital ICUs rose 30 percent.
  • Fifty-two of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, down from 62 counties last week.  Four counties experienced a moderate rate of community transmission and 11 a substantial rate.

Monkeypox

The Department of Health has issued a health alert advising providers about the current state of availability of testing for monkeypox and when providers should consider pursuing such testing for their patients.  Find that alert here.

The CDC has posted an updated map showing the distribution of 1053 confirmed cases of monkeypox in the U.S. as of July 13, 32 of them in Pennsylvania and more than half of those cases in Philadelphia.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – July 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, July 27 at 1:00.  Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – July 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, July 28 at 10:00.  Go here to register to participate.

Department of Health – Special Pharmaceutical Benefits Program Advisory Council – July 28

The Department of Health’s Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public teleconference meeting on Thursday, July 28, 2022, from 10 a.m. to 12 p.m. The SPBP Advisory Council will provide program guidance and recommendations to the Department’s SPBP in regard to the following: drug formulary; covered lab services; drug utilization review; clinical programs; eligibility; and program management. Learn more about the meeting and how to register to participate in this notice.

 

2022-07-18T17:02:52+00:00July 18th, 2022|COVID-19, Medical Assistance Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2023 budget|Comments Off on PA Health Policy Update for Friday, July 15

PA Health Policy Update for Friday, July 8

The following is an update of selected state health policy developments in Pennsylvania for the week of July 5-8, 2022.  (Some of the language used below is taken directly from state documents.)

FY 2023 Budget Update

Governor Wolf and the General Assembly reached a final budget agreement for FY 2022-2023 this week.  In total the budget spends $45.3 billion, which is $1.3 billion more than the prior fiscal year’s budget.  The budget makes significant investments in education, housing, child tax credits, health care, and property tax and rent rebate programs.  It also allocates $2.1 billion to the state’s rainy day fund.  The following is an overview of budget-related bills and their status as of 2:00 p.m. on Friday, July 8.

  • Senate Bill 1100 is the General Appropriations bill.  The House passed the bill by a vote of 180-20 and the Senate subsequently concurred with House amendments by a vote of 47-3.  The bill has been presented to the governor for his signature.
  • The Fiscal Code bill is House Bill 1421, which is scheduled to be considered off the floor by the Senate Rules & Executive Nominations Committee Friday afternoon.
  • The Human Services Code bill is House Bill 1420It passed the House and Senate on Thursday but Governor Wolf vetoed the bill early Friday.  The Senate is expected to amend Human Services Code language, with the exception of the “Agency with Choice” delay, into the Fiscal Code later today and send it to the House for concurrence.
  • House Bill 1342 is the Tax Code bill.  The Senate and House both passed this yesterday.  It was presented to the governor and is currently awaiting his signature.

Governor Wolf

  • Governor Wolf signed House Bill 1561 and House Bill 1563 into law this week.  These bills, which are now Act 32 and 33 of 2022, amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, to align them with HIPAA and give providers, facilities, and insurers the ability to share more easily patient mental health and substance use disorder treatment information.  Both pieces of legislation were presented to Governor Wolf for his signature.
  • Governor Wolf signed Senate Bill 861, which enters Pennsylvania into the EMS compact, on third and final consideration.  The bill has been presented to Governor Wolf for his signature.

General Assembly

The state House and Senate remain in session while they work to finalize the FY 2023 budget and pass legislation before they recess and are not scheduled to return to Harrisburg until mid-September.  The following is an overview of action taken by the General Assembly as of Friday, July 8 at 2:00 p.m.

  • The Senate voted to concur with House amendments to Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers with those permitted by the Centers for Medicare & Medicaid Services (CMS), and sent it to Governor Wolf for his signature.
  • The Senate passed House Bill 2679 on third and final consideration.  The bill, which is now on the governor’s desk, authorizes pharmacists and pharmacy interns to administer influenza and COVID-19 vaccines to individuals five and older.
  • The Senate passed House Bill 2604, which amends the requirement for health care facility ID badges to permit the use of health system names rather than specific licensed facility names.  The bill is now on the governor’s desk.
  • The Senate passed House Bill 2032, which states that a health care professional’s failure to report a victim’s injuries to law enforcement as required by the Crimes Code does not constitute a criminal offense when a sexual assault victim wishes to remain anonymous.  The bill is now on the governor’s desk for his signature.
  • The Senate passed Senate Bill 106 and sent it to the House for concurrence.  Senate Bill 106 includes a number of constitutional amendments, including one establishing that the state constitution does not grant the right to taxpayer-funded abortion or any other rights relating to abortion.
  • The Senate passed House Bill 2419, which expands access to outpatient psychiatric care via telemedicine, and sent it to Governor Wolf for his signature.
  • The House passed Senate Bill 1235, which prohibits the Department of Human Services from developing or using bidding or service zones that limit a health service corporation or hospital plan corporation contractor from submitting bids.  The bill is now on the governor’s desk.

Department of Human Services

  • The Department of Human Services (DHS) has proposed amending the state’s Human Services Code to enable individuals who are 14 years of age or older but under 18 years of age who meet the admission requirements to gain access to psychiatric rehabilitation services; to amend the diagnoses that enable an individual to obtain those services without use of the exception process; and to revise outdated language and add definitions of ”serious mental illness” and ”serious emotional disturbance” that align with definitions currently used by the Federal Substance Abuse and Mental Health Services Administration.  Learn more about what DHS has proposed and why it has proposed it in this Pennsylvania Bulletin notice.
  • DHS has published a Medical Assistance Bulletin announcing the addition of procedure code A4928 to the Medical Assistance fee schedule for disposable surgical masks dispensed to Medical Assistance beneficiaries effective with dates of service on and after July 1, 2022.  This bulletin applies to Medical Assistance-enrolled certified registered nurse practitioners, physician assistants, physicians, podiatrists, and medical suppliers that prescribe or dispense disposable surgical masks to Medical Assistance beneficiaries in the fee-for-service and managed care delivery systems.  Find the bulletin here.
  • DHS has published a series of Medical Assistance Bulletins to issue updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of certain prescriptions.  These bulletins apply to all licensed pharmacies and prescribers enrolled in the Medical Assistance program.  The types of prescriptions covered by these bulletins are:
  • DHS has posted the minutes of the June 23 meeting of its Medical Assistance Advisory Committee meeting.  Find those minutes here.
  • DHS also has posted the minutes of the June 22 meeting of the Medical Assistance Advisory Committee’s consumer subcommittee.  Find those minutes here.

Department of Health

  • The Department of Health (DOH) has updated its guidance to hospitals in response to Act 30 of 2022, recently passed by the state legislature, which extends COVID-19-related waivers through October 31, 2022.  Among other things, this guidance addresses mandatory data reporting, suspension of services, alternative uses of hospital space, hospital-based laboratory analysis of COVID-19 tests, mandatory patient COVID-19 testing, and more.  For a complete review of the implications of Act 30 for hospitals, see this updated DOH guidance.
  • DOH has announced that its COVID-19 community-based testing sites will now offer three forms of free testing:  point-of-care tests where tests are performed and results are analyzed on-site; the distribution of at-home COVID-19 antigen tests; and continued administration of mid-nasal passage swab PCR testing.  The department currently operates testing locations in Berks, Blair, Centre, Clarion, Clinton, Erie, and Washington counties.  Learn more from this DOH announcement.
  • “COVID Alert PA,” DOH’s COVID-19 app that advises users of potential exposure to individuals diagnosed with COVID-19 and provides updated data on the state of the pandemic in Pennsylvania, has a new message informing users that “The current app will be discontinued on July 27, 2022.”

COVID-19:  By the Numbers

  • The daily average of newly reported COVID-19 cases fell 10 percent over the past week, to 2440 cases a day.
  • COVID-19-related deaths in the past week were the same as they were the week before.
  • The number of Pennsylvanians hospitalized with COVID-19 remained generally steady over the past week, as did the number of COVID-19 patients in hospital intensive care units and on ventilators.
  • Sixty-two of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, up from 35 counties last week.  The remaining five counties (Clarion, Forest, Potter, Sullivan, and Tioga) experienced a substantial rate of community transmission.

State Board of Pharmacy

The State Board of Pharmacy has published a final rule in the Pennsylvania Bulletin related to the administration of injectable medications, biologicals, and immunizations.  The rule allows pharmacists to administer influenza immunizations by injectable or needle-free delivery methods to children nine years of age and older.  Additionally, qualified and authorized pharmacy interns are permitted to administer injectable medications, biologicals, and immunizations to persons 18 years of age or older and administer influenza immunizations by injectable or needle-free delivery methods to children ages nine years and older under certain conditions.  Find the bulletin here.

Stakeholder Events

Department of Health – COVID-19 Therapeutics – July 12

The Department of Health, Department of Human Services, and Pennsylvania Emergency Management Agency will hold a webinar on COVID-19 therapeutics on Tuesday, July 12 at 4:00.  The webinar is intended for providers and facility administrators and will cover why, when, and
how to prescribe and obtain outpatient COVID-19 treatment and preventive therapies.  Learn more about the webinar and how to register to participate in this notice.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – July 14

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will meet virtually on Thursday, July 14 from 10 a.m. until 1 p.m.  The agenda will include discussions about board member terms; updates from the Bureau of Family Health; payment options for additional conditions; research on dried blood spot specimens; a discussion on metachromatic leukodystrophy; and updates from the ethics, lysosomal storage disorders/X-ALD, cystic fibrosis, hemoglobinopathy, and critical congenital heart defects subcommittees.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – July 14

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a special populations webinar on “Filling the Day With Meaning:  Thinking Outside the Box.”  The webinar, to be held on Thursday, July 14 at 2:00, will seek to share with participants the benefits of meaningful engagement for residents living with dementia and is especially directed toward special population workers involved in recreational therapy, restorative team members, CNAs, and volunteers.  Learn about registration and how to join the webinar from this notice.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – July 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, July 27 at 1:00.  Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – July 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, July 28 at 10:00.  Go here to register to participate.

PA Health Policy Update for Friday, July 1

The following is an update of selected state health policy developments in Pennsylvania for the week of June 27 to July 1, 2022.  (Some of the language used below is taken directly from state documents.)

FY 2023 Budget Update

As of 2:00 p.m. on Friday, July 1, Governor Wolf and the General Assembly continue to work on finalizing Pennsylvania’s FY 2023 budget.  Despite indications that a framework for a budget agreement has been reached, the state missed its June 30 deadline to enact a spending plan.  The General Assembly is scheduled to return to session next Tuesday, July 5 to continue its work. The short-term impact of not having a budget by July 1 will be minimal; the state is obligated to maintain essential operations and cover Medicaid expenditures, state employee payroll, and debt payments.

Harrisburg, PA capital buildingGeneral Assembly

The state House and Senate cancelled session this weekend and are schedule to return to session on Tuesday, July 5.  Depending on the outcome of budget negotiations and the progress of budget-related legislation, they may have to add additional session days next week.

  • The Senate passed House Bill 1561 and House Bill 1563 on third and final consideration.  These bills amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, to align them with HIPAA and give providers, facilities, and insurers the ability to share more easily patient mental health and substance use disorder treatment information.  Both pieces of legislation were presented to Governor Wolf for his signature.
  • The Senate passed Senate Bill 225 on third and final consideration.  The bill seeks to streamline and standardize the process for prior authorization of medical services.  The bill was sent to the House and referred to the Insurance Committee for consideration.
  • The House passed Senate Bill 861, which enters Pennsylvania into the EMS compact, on third and final consideration.  The bill has been presented to Governor Wolf for his signature.
  • The House passed Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers in Pennsylvania with those permitted by the federal Centers for Medicare & Medicaid Services (CMS), on third and final consideration.  Since the bill was amended, it was sent back to the Senate for concurrence.
  • The House passed House Bill 2679 on third and final consideration.  The bill, which was subsequently sent to the Senate for consideration, authorizes pharmacists and pharmacy interns to administer influenza and COVID-19 vaccines to individuals five years of age and older.
  • The House unanimously voted to concur with Senate amendments to House Bill 2097, which makes permanent a COVID-19 regulatory waiver that permits certified emergency personnel, such as firefighters with specific first-aid, CPR, and emergency vehicle training, to drive ambulances with an EMT on board.  The bill will now be sent to the governor for his signature.
  • The House passed House Bill 2293 on third consideration and final passage and sent it to the Senate for consideration.  This bill requires the registration and oversight of contract health care service agencies that provide temporary employment in certain health care facilities.

Governor Wolf

Governor Wolf has signed into law House Bill 2401, which extends regulatory waivers that went into effect over the course of the COVID-19 pandemic.  This extension will permit many waivers to remain in place until October 31, 2022 unless the waivers are related to federal exemptions.  Waivers related to federal exemptions will remain in place until the last day of the federal public health emergency or the last day the federal exemptions are authorized, whichever is later.  House Bill 2401 also makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.  Learn more from this Wolf administration news release.

Governor Wolf has signed Senate Bill 709, which establishes the CMV Education and Newborn Screening Act and requires the Department of Health to make available on its website certain information regarding cytomegalovirus (CMV), one of the most common viral infections that infants are born with in this country.  Health care providers will be required to provide parents or guardians of newborns with information on CMV and to offer a screening or referral within 21 days if the newborn child fails the initial newborn hearing screening.  Learn more from this Wolf administration news release and Senate Bill 709 (now Act 29).

Department of Human Services

  • In response to the COVID-19 emergency, the federal Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) in April of 2020 issued an exemption to opioid treatment programs from the requirement to perform an in-person physical evaluation for any patient who will be treated by such programs with buprenorphine if a program physician, primary care physician, or an authorized health care professional under the supervision of a program physician determines that an adequate evaluation of the patient can be accomplished via telehealth.  Based on positive response to this practice, SAMHSA is extending this flexibility for one year from the formal end of the COVID-19 public health emergency.  Learn more from SAMHSA’s guidance.
  • The Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services has issued a bulletin to update its guidelines for payment of behavioral health services delivered using telehealth technology.  Find the bulletin here and attachments here and here.  The new guidelines take effect immediately.
  • DHS’s Breast & Cervical Cancer Prevention & Treatment Program provides eligible individuals treatment for confirmed cases of breast and cervical cancer or pre-cancerous conditions of the breast or cervix.  DHS has posted a notice to providers reminding them how to determine whether patients may be eligible for services under the program and, if they are, how they can enroll in the program.  Find that notice here.
  • DHS has issued a Medical Assistance Bulletin informing providers that as of November 1 it will reinstate the prior authorization requirements for shift care services provided to beneficiaries under the age of 21 in the Medical Assistance fee-for-service program.  Medical Assistance managed care organizations may reinstate the prior authorization requirements for these services provided to children under the age of 21.  Providers rendering services in the managed care delivery system should contact the appropriate managed care organization regarding any questions about prior authorization requirements.  Learn more from this Medical Assistance Bulletin.
  • DHS has announced a funding opportunity for home and community-based service (HCBS) providers to improve and strengthen HCBS programs and services to better serve HCBS participants.  Under the program DHS will provide up to $40,000 for each approved request to help HCBS providers implement a series of specific types of service improvement projects.  Funding is limited to providers of services through the Community HealthChoices and OBRA 1915(c) waivers for activities that supplement HCBS services rather than supplant existing services.  Learn more about the funding program and the specific types of projects DHS is interested in supporting from this DHS news release.  For more detailed information, see this DHS description of the program, the funding guidelines, and how to apply.  Applications will be accepted until December 31 or whenever the $38 million allocated for this purpose has been committed.  All awarded funds must be spent by July 1, 2023.
  • DHS is seeking partners to help it through the public health emergency unwinding process during which people will need to re-establish their eligibility for Medical Assistance benefits.  Specifically, it seeks individuals and organizations that will help guide current Medical Assistance beneficiaries through the eligibility renewal process or direct them to other resources for possible health care coverage.  Learn more about what DHS seeks and how to participate in this undertaking from this DHS message.
  • DHS has decreased from 90 to 30 days the period of time individuals have to request a hearing appealing a Medicaid termination or denial.  The time limit previously was 30 days, was extended to 90 days at the start of the COVID-19 public health emergency, and has now been restored to 30 days.  Find the notice in this DHS memo (on page 7, in red).
  • DHS and the Department of Transportation have been awarded a $750,000 grant from the Federal Transit Administration to expand its Find My Ride online tool, Pennsylvania’s “one-stop shop” for access to human services transportation.  The program was developed collaboratively with transit agencies and streamlines the application process for the five largest transportation assistance programs in the state, including the Senior Share Ride program, the Medical Assistance Transportation Program, ADA complementary paratransit, the Persons with Disabilities Program, and the Free Transit Program.  The program enables third parties, such as family members or health care providers, to apply for services on behalf of riders.  Learn more from this Wolf administration news release.

Insurance Department

The Insurance Department has received a federal grant as part of the State Flexibility to Stabilize the Market Grant Program Cycle II.  One of the proposed projects includes studying the availability of providers in various specialties and geographic areas.  The goal of this study is to understand areas of need based on the current availability of providers to accept new patients and the amount of time it takes to get an appointment with these providers and to assess network adequacy considerations based on the findings.  The Insurance Department is seeking public comment from organizations, consumer advocates, providers, and consumers about their experience with getting appointments or finding available specialists.  Learn more about the project and the areas of medical specialty the analysis may consider, and on which the department is interested in comments, in this Pennsylvania Bulletin notice.  Comments are due by August 5.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has announced the availability of $3 million in funding for entities to provide pregnancy support services to address the needs of pregnant and postpartum women with substance use disorder.  Last year the program awarded $599,000 to 12 organizations and this year the Department of Drug and Alcohol Programs plans to award approximately three to five grants of up to $600,000 each to help provide services, streamline care, and assure that this population is connected with the most appropriate resources to reach long-term recovery.  Learn more about this funding opportunity from this department news release and a program overview that describes eligible applicants and outlines the application process.  Applications are due by July 29 for projects that begin on October 1 and end by September 30, 2023.

COVID-19:  By the Numbers

  • After four weeks of falling case counts the number of new reported COVID-19 cases rose over the past week.
  • During this past week, Pennsylvania’s total of COVID-19 cases since the beginning of the pandemic rose past three million.
  • COVID-19-related deaths rose slightly during the week.
  • The number of Pennsylvanians hospitalized with COVID-19 remained steady over the past week but the number in hospital intensive care units and on ventilators declined.
  • Thirty-five of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, down from 55 counties last week.  Four counties experienced a moderate rate of community transmission and the remaining 18 experienced a substantial rate.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

Pennsylvania Health Care Cost Containment Council – July 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will meet virtually on Thursday, July 7 at 10:00.  For access to the meeting agenda and information about how to participate, see this Pennsylvania Bulletin notice.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – July 7

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar to help nursing facility staff recognize expressions of behavior among residents living with dementia.  The webinar will be held on Thursday, July 7 at 2:00.  Learn more about the webinar and how to participate from this notice.

Department of Health – COVID-19 Therapeutics – July 12

The Department of Health, Department of Human Services, and Pennsylvania Emergency Management Agency will hold a webinar on COVID-19 therapeutics on Tuesday, July 12 at 4:00.  The webinar is intended for providers and facility administrators and will cover why, when, and
how to prescribe and obtain outpatient COVID-19 treatment and preventive therapies.  Learn more about the webinar and how to register to participate in this notice.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – July 14

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will meet virtually on Thursday, July 14 from 10 a.m. until 1 p.m.  The agenda will include discussions about board member terms; updates from the Bureau of Family Health; payment options for additional conditions; research on dried blood spot specimens; a discussion on metachromatic leukodystrophy; and updates from the ethics, lysosomal storage disorders/X-ALD, cystic fibrosis, hemoglobinopathy, and critical congenital heart defects subcommittees.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

PA Health Policy Update for Friday, June 17

The following is an update of selected state health policy developments in Pennsylvania for the week of June 13-17, 2022.  (Some of the language used below is taken directly from state documents.)

Bookshelf with law booksGeneral Assembly

  • The state House and Senate convened for voting session this week in Harrisburg.
  • The Senate passed on final consideration Senate Bill 967, which creates the Women, Infants, and Children State Advisory Board.  The bill will now be sent to the House for consideration.
  • The House passed Senate Bill 709 on third consideration and final passage.  This bill establishes the CMV Education and Newborn Testing Act to create public awareness of cytomegalovirus and provide for CMV screening for certain newborns.  The bill will now be sent back to the Senate for concurrence.
  • The House also passed Senate Bill 915, which is the capital budget bill, on third consideration and final passage.  This will be sent back to the Senate for concurrence as well.
  • The House Health Committee convened on Monday, June 13 and favorably reported, among others, the following health care-related bills:
    • House Bill 2357, the Kratom Consumer Protection Act, which prohibits the preparation, manufacture, sale, or distribution of unsafe kratom products and the sale or distribution of kratom products to individuals younger than 21 years of age.
    • House Bill 2579, which seeks to increase the number of EMTs and paramedics in Pennsylvania by requiring the Department of Health to develop state-specific examinations for EMTs, EMRs, and paramedics and no longer rely on the National Registry exam.
    • House Bill 2604, which amends the requirement for health care facility ID badges to permit the use of health system names rather than specific licensed facility names.
  • House Bill 2604 was subsequently amended on the House floor during second consideration.  The amendment, which makes certain changes and adds a definition of “health system,” was agreed to by stakeholders and the Department of Health.
  • The House Insurance Committee convened on Tuesday, June 14 and favorably reported Senate Bill 1235, which prohibits the Department of Human Services from developing or using bidding or service zones that limit a health service corporation or hospital plan corporation contractor from submitting bids.
  • The House Veterans Affairs & Emergency Preparedness Committee met on Wednesday, June 15 and favorably reported, among other bills, Senate Bill 861 which enters Pennsylvania into the EMS Compact.
  • The state House and Senate will convene next Monday (6/20) through Friday (6/24) for voting session.

Department of Human Services

  • The Department of Human Services has issued a Medical Assistance Bulletin to notify dentists, federally qualified health centers, and rural health clinics that Medical Assistance will pay for teledentistry, effective with dates of service on and after May 2, 2022, and to announce that procedure codes for counseling services have been added to the MA program fee schedule.  Find the bulletin here.
  • The Department of Human Services has posted the contract into which it has entered HealthChoices physical health managed care organizations effective January 1, 2022.  Find that contract here.

COVID-19:  By the Numbers

  • For the third consecutive week COVID-19 case counts fell, declining from a seven-day average of 3223 on June 8 to 2143 on June 15, a 34 percent decline.
  • The seven-day average of COVID-19-related deaths also fell, from 23 to 16, over the same period of time.
  • The number of Pennsylvanians hospitalized with COVID-19 and on ventilators and in hospital intensive care units all declined over past week.
  • Fifty-six of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, down from 65 counties last week.  Two counties experienced moderate rates of community transmission and nine experienced a substantial rate.

Stakeholder Events

Rural Health Redesign Center Authority – June 21

The board of the Pennsylvania Rural Health Redesign Center Authority will meet virtually on Tuesday, June 21 at 10:00.  Learn more about the board and how to participate in this meet from this Pennsylvania Bulletin notice.

Department of Health – Preventative Health and Health Services Block Grant Application for Federal Fiscal Year 2022; Public Hearing – June 21

The Department of Health is making available copies of its proposed Preventive Health and Health Services Block Grant Application for federal FY 2022.  This block grant application shall serve as the state’s request to the U.S. Department of Health and Human Services for block grant funding to address the Healthy People 2030 Health Status Objectives.  A public hearing will be held virtually on June 21 at 10:00.  Learn more about the hearing, how to participate, and how to obtain a copy of the grant funding application from this Pennsylvania Bulletin notice.

Department of Health – Health Research Advisory Committee – June 21

The Department of Health’s Health Research Advisory Committee will meet virtually on Tuesday, June 21 at noon.  The purpose of the meeting is to vote on 2022 priorities and to plan for future health research priorities.  For information about how to join the meeting see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – June 22

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, June 22 at 1:00.  For information about how to join the meeting, go here.

Department of Human Services – Medical Assistance Advisory Committee – June 23

The Medical Assistance Advisory Committee will meet virtually on Thursday, June 23 at 10:00.  Go here to register to join the meeting.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 23

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a “learning collaborative” webinar in which participants in past Long-Term Care Learning Network events share information about best practices for avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, June 23 at 2:00 and the deadline to sign up to share best practices is June 1.  For further information about the webinar, sharing best practices, and participating virtually, go here.

Patient Safety Authority – June 23

The board of the Patient Safety Authority will meet virtually on Thursday, June 23 at 1:00.   Registration is required.  Learn about how to participate in the meeting from this Pennsylvania Bulletin notice.

Department of Health – Public Health Advisory Council – June 27

The Department of Health’s Public Health Advisory Council will meet virtually on Monday, June 27 at 2:00.  The purpose of the meeting is to discuss the Preventive Health and Health Services Block Grant Federal Fiscal Year 2022 work plan.  For additional information about the meeting and how to participate, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

2022-06-17T21:32:45+00:00June 17th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for Friday, June 17

PA Health Policy Update for Friday, June 10

The following is an update of selected state health policy developments in Pennsylvania for the week of June 6-10, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has signed House Bill 889, which authorizes the State Board of Nursing to approve graduates of international nursing education programs to sit for the RN licensure examination provided that such international programs are determined to be equivalent to that which is required in Pennsylvania.  The bill is now Act 22 of 2022.

General Assembly

  • The state House and Senate convened for voting session this week in Harrisburg.
  • The House passed on final consideration House Bill 2585, which prohibits the Department of Human Services from developing or using bidding or service zones that limit a health service corporation or hospital plan corporation contractor from submitting a bid.  The bill will now be sent to the Senate for consideration.  The Senate passed a companion bill, Senate Bill 1235, which will now be sent to the House for consideration.
  • The House Insurance Committee held an informational meeting on Wednesday, June 8 to examine cybersecurity and insurance data security.  Find a recording of the hearing here.
  • The Senate Health & Human Services Committee met on June 7 and favorably reported the following bills.
    • Senate Bill 571, which establishes a uniform time frame for distributing SNAP benefits.
    • Senate Bill 1198, which seeks to promote and improve the availability of and access to assisted living residences.
    • Senate Bill 1202, which requires health insurers to cover the use of medically prescribed pasteurized donor human milk in inpatient and outpatient settings for children under the age of 12 months.
    • House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.

Find a recording of the hearing here.

  • The Senate Veterans Affairs & Emergency Preparedness Committee met on Monday and favorably reported House Bill 2097, which makes permanent a COVID-19 regulatory waiver that permits certified emergency personnel, such as firefighters with specific first-aid, CPR, and emergency vehicle training, to drive ambulances with an EMT on board.

Department of Human Services

  • The Department of Human Services (DHS) has updated its Act 2 payment guidance to incorporate additional questions the department has received.  The updated guidance provides further clarification on eligible staff, employer tax withholding, and more.   Find the expanded guidance here.
  • DHS has unveiled new provider enrollment portal enhancements designed to improve providers’ enrollment experience.  Learn more about these enhancements here.
  • DHS has issued a Medical Assistance Bulletin to inform providers enrolled in the Medical Assistance program that it has updated its blood lead reference value and updated the qualifications for environmental lead investigators to enroll in the program.  Find that Medical Assistance Bulletin here.
  • DHS has issued a Medical Assistance Bulletin to inform Federally Qualified Health Centers and Rural Health Clinics that it is implementing an alternative payment methodology to pay the Medical Assistance program fee schedule rate for administering COVID-19 vaccines during vaccine-only visits for dates of service on and after December 1, 2020 and that it will pay the enhanced Medical Assistance program fee schedule rate for administering COVID-19 vaccines to homebound Medical Assistance beneficiaries during vaccine-only visits for dates of service on and after April 1, 2021.  Find that Medical Assistance Bulletin here.
  • DHS has posted the minutes of the May 26 meeting of the Medical Assistance Advisory Committee.  Find those minutes here.

HealthChoices Changes

Department of Health

  • The Department of Health (DOH) has issued a health advisory alerting providers to an anticipated seasonal increase in Legionella infections combined with a potential increase in cases resulting from changing building occupancies.  The advisory describes the symptoms of Legionella infection, risk factors, testing, and treatment and provides links to additional resources.  Find the health advisory here.
  • DOH has sent a reminder to long-term-care facilities about the outpatient COVID-19 therapeutics available to them and how to obtain these medications through the agency’s health care partner portal.
  • DOH has shared recommendations for residents of long-term-care facilities (a Word download) to receive a second COVID-19 vaccine booster this summer based on updated CDC guidance.

COVID-19:  By the Numbers

  • The Department of Health has issued its monthly report on COVID-19 trends in Pennsylvania.  Find it here.
  • For the second consecutive week COVID-19 case counts fell, declining from a seven-day average of 3552 on June 1 to 3228 on June 8, a nine percent decline.
  • The seven-day average of COVID-19-related deaths rose, however, from 15 to 23, over the same period of time.
  • The number of Pennsylvanians hospitalized with COVID-19 and on ventilators and in hospital intensive care units remained mostly steady over the past week.
  • Sixty-five of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19.  The exceptions were Juniata County, with a moderate rate of community transmission, and Fulton County, with a substantial rate.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has published volume one of its annual analysis of the financial performance of Pennsylvania’s acute-care hospitals.  The analysis found that hospital total margins across the state increased 7.84 percentage points, from 3.93 percent in FY 2020 to 11.77 percent in FY 2021, and statewide operating margins increased 4.18 percentage points, from 3.73 percent in FY 2020 to 7.91 percent in FY 2021.  The analysis also found that in FY 2021, 25 percent of the state’s acute-care hospitals posted a negative total margin, 10 percent posted a total margin between 0 percent and four percent, and the remaining 65 percent posted a total margin higher than four percent.  The analysis found that for FY 2021, acute-care hospitals’ uncompensated care rose from $832 million in the previous year to $866 million, an increase of 4.1 percent.  Go here to find a PHC4 news release describing the agency’s report, the report itself, and a link to downloadable data from the report.

Stakeholder Events

Rural Health Redesign Center Authority – June 21

The board of the Pennsylvania Rural Health Redesign Center Authority will meet virtually on Tuesday, June 21 at 10:00.  Learn more about the board and how to participate in this meet from this Pennsylvania Bulletin notice.

Department of Health – Preventative Health and Health Services Block Grant Application for Federal Fiscal Year 2022; Public Hearing – June 21

The Department of Health is making available copies of its proposed Preventive Health and Health Services Block Grant Application for federal FY 2022.  This block grant application shall serve as the state’s request to the U.S. Department of Health and Human Services for block grant funding to address the Healthy People 2030 Health Status Objectives.  A public hearing will be held virtually on June 21 at 10:00.  Learn more about the hearing, how to participate, and how to obtain a copy of the grant funding application from this Pennsylvania Bulletin notice.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 23

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a “learning collaborative” webinar in which participants in past Long-Term Care Learning Network events share information about best practices for avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, June 23 at 2:00 and the deadline to sign up to share best practices is June 1.  For further information about the webinar, sharing best practices, and participating virtually, go here.

Patient Safety Authority – June 23

The board of the Patient Safety Authority will meet virtually on Thursday, June 23 at 1:00.   Registration is required.  Learn about how to participate in the meeting from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

 

 

PA Health Policy Update for Friday, June 3

The following is an update of selected state health policy developments in Pennsylvania for the week of May 31 to June 3, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

  • The state House and Senate will return to Harrisburg for session the week of June 6.  The Senate will be in session on Monday (6/6), Tuesday (6/7), and Wednesday (6/8).  The House will be in session on Tuesday (6/7), Wednesday (6/8), and Thursday (6/9).
  • The House Health Committee will hold a joint hearing with the Environmental Resources & Energy Committee on “Oil and gas byproducts:  powering modern medicine and our healthcare system.”  The hearing will take place on Tuesday, June 7 at 10:00 a.m.
  • The House Insurance Committee will hold an informational meeting on Wednesday, June 8 at 10:00 a.m. to examine cybersecurity and insurance data security.
  • The Senate Health & Human Services Committee will meet on Tuesday, June 7 at 10:30 a.m. to consider the following bills.
    • Senate Bill 571, which establishes a uniform time-frame for distribution of SNAP benefits.
    • Senate Bill 1198, which seeks to promote and improve the availability of and access to assisted living residences.
    • Senate Bill 1202, which requires health insurers to cover the use of medically prescribed pasteurized donor human milk in inpatient and outpatient settings for children under the age of 12 months.
    • House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.

Revenue Collection Update

The Independent Fiscal Office (IFO) has released its Monthly Revenue Update for May. General Fund revenue collection exceeded estimate by $459.1 million for the month.  For the fiscal year to date Pennsylvania has received $5.5 billion more than projected.  The IFO reported that increased revenue collections continue to be driven by strong sales and use tax, personal income tax,  and corporate net income tax payments.

Department of Human Services

  • The Department of Human Services (DHS) has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added a CPT code to the MA fee schedule for the administration of a third dose of the Pfizer pediatric COVID-19 vaccine.  Find that notice here.  The notice is retroactive to January 3.
  • DHS has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT codes to the MA fee schedule for the administration of Pfizer’s ready-to-use novel COVID-19 vaccine.  Find that notice here.  The notice is retroactive to January 3.
  • The managed care delivery system subcommittee of DHS’s Medical Assistance Advisory Committee has posted a draft file note summarizing its May 12 public meeting.  Find that draft here.

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has released a new tool states can use to prepare for the eventual end of the COVID-19 public health emergency and return to normal Medicaid and CHIP eligibility and enrollment operations.  This tool highlights the ten fundamental actions states need to complete to prepare for unwinding when the Medicaid continuous enrollment requirement ends.  Find it here.

CMS has issued a letter to state Medicaid programs updating its 2022 SSI and spousal impoverishment standards.  These measures affect financial eligibility rules (the “spousal impoverishment rules”) that apply when married individuals seek coverage of certain long-term services and supports.  Find the letter and the new standards here.

Department of Health

The Department of Health is working with Philadelphia’s Department of Public Health to confirm and investigate what appears to be the first case of monkeypox in Pennsylvania and one of only 21 currently suspected in the U.S.  Learn more from this Philadelphia Department of Public Health news release.

The Department of Health’s Bureau of Epidemiology and Bureau of Facility Licensure and Certification have notified skilled nursing facilities of modifications of the reporting process for skilled nursing facilities with ongoing outbreaks of COVID-19.  Find that notice here.

COVID-19:  By the Numbers

  • For the first time in more than two months daily COVID-19 case counts fell, declining from a seven-day average of 4238 on May 25 to 3552 on June 1.
  • The seven-day average of COVID-19-related deaths fell by more than half, from 36 to 15, over the same period of time.
  • Despite the decline in new cases, the number of Pennsylvanians hospitalized with COVID-19 rose, but only slightly (three percent) over the past week.
  • The number of these patients on ventilators and hospital intensive care units held steady over the past week.
  • Sixty-six of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19; Juniata County was the exception, with a substantial rate of community transmission.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has awarded a grant of $1.4 million to continue the Pennsylvania Perinatal Quality Collaborative’s work in improving perinatal health outcomes.  Learn more about the grant, the program, and the grant recipient from this department news release.

Independent Regulatory Review Commission

Pennsylvania’s Independent Regulatory Review Commission has issued comments on proposed regulations governing long-term-care facilities that were published on March 19.  See these comments in this Pennsylvania Bulletin notice.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Managed Care Delivery System Subcommittee – June 9

The Medical Assistance Advisory Committee’s managed care delivery system subcommittee will meet virtually on Thursday, June 9 at 10:00.  Go here for the meeting agenda and information about how to participate.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 9

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a special population webinar on polypharmacy challenges in nursing homes on Thursday, June 9 at 2:00.  The webinar is especially targeted for skilled nursing facility medical directors, directors of nursing, pharmacy staff, and recreational therapy.  To learn more about the virtual webinar and how to participate, go here.

Department of Aging – Pennsylvania Long-Term Care Council – June 9

The Department of Aging’s Pennsylvania Long-Term Care Council will meet in Harrisburg on Thursday, June 9 at 10:00; the meeting also will be available virtually.  For information on the location of the meeting and how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 23

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a “learning collaborative” webinar in which participants in past Long-Term Care Learning Network events share information about best practices for avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, June 23 at 2:00 and the deadline to sign up to share best practices is June 1.  For further information about the webinar, sharing best practices, and participating virtually, go here.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually.  For further information about the location of the meeting and how to participate virtually, see this announcement.

PA Health Policy Update for the Week of May 9-13

The following is an update of selected state health policy developments in Pennsylvania for the week of May 9-13, 2022.  (Some of the language used below is taken directly from state documents.)

Primary Election

Pennsylvania’s 2022 primary election will be held on Tuesday, May 17.  Registered Republicans and Democrats will have an opportunity to select which candidates will represent their parties in the general election for local and statewide races, including governor, lieutenant governor, U.S. senator, U.S. representative, state senator, and state House representative.

General Assembly

The Joint State Government Commission issued a report this week regarding nurse licensure in the commonwealth.  House Resolution 142 directed the Joint State Government Commission to conduct a review of the State Board of Nursing, specifically the “authorization to test” process and how it might be improved.  Among other recommendations, the report highlights the need for additional staff at the state Board of Nursing, improved processing of licensure applications, and revision of the criminal background check process.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to inform providers of the addition of CPT codes M0222 and M0223 to the program’s fee schedule for the administration of the monoclonal antibody bebtelovimab for treatment of COVID-19 effective February 11, 2022.  Find that bulletin here.
  • DHS has published a Medical Assistance Bulletin to issue its 2022 immunization schedule for Medical Assistance beneficiaries ages 18 years or younger.  Find the bulletin here.
  • DHS has published a final notice of its funding allocation for FY 2022 for several classes of inpatient disproportionate share hospital (Medicaid DSH) and supplemental payments to Medical Assistance-enrolled and qualifying inpatient acute-care general hospitals.  The funding allocation is for DSH and supplemental payments for inpatient care, critical access hospitals, burn centers, obstetric and neonatal services, academic medical centers, physician practice plans, autism intervention, and trauma centers.  DHS is not changing the qualifying criteria or payment methodology for these payments and the notice does not list allocations to individual recipients.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued a flyer explaining how individuals and organizations can obtain doses of Naloxone, the life-saving medication used in the event of a suspected opioid overdose.
  • DHS has posted the minutes of the April 28 meeting of its Medical Assistance Advisory Committee.
  • The federal Centers for Medicare & Medicaid Services (CMS) has released a “State Health Official Letter” to provide guidance to states on coverage and payment for stand-alone vaccine counseling in Medicaid and CHIP.  In the letter, CMS explains that it is interpreting the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit to require the provision of stand-alone vaccine counseling to eligible beneficiaries.  This guidance links the mandatory COVID-19 vaccine and vaccine administration coverage and reimbursement under the American Rescue Plan with the health education requirement under Medicaid’s EPSDT benefit.  Learn more from the CMS letter to state health officials.
  • CMS has published its reassignment of Medicaid provider claims final rule.  This rule reinterprets the scope of the general requirement that state payments for Medicaid services must generally be made directly to the individual practitioner or institution providing services or to the beneficiary in the case of a class of practitioners for which the Medicaid program is the primary source of revenue.  Specifically, this final rule explicitly authorizes states to make payments to third parties on behalf of individual practitioners for practitioners’ health insurance and welfare benefits, skills training, and other benefits customary for employees if the individual practitioner consents to such payments on their behalf.  This rule is generally viewed as an effort to aid home health care workers.  See the final rule here.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed for the seventh consecutive week – this week, significantly.  The state’s seven-day average of new cases rose 65 percent, from 1874 on May 5 to 3101 on May 12.
  • The seven-day average of COVID-19-related deaths rose from ten on May 6 to 12 on May 12.
  • The growing number of COVID-19 cases in the state has led to a large but not proportional increase in COVID-19-related hospitalizations:  after consecutive weeks of 22 percent increases in hospitalizations, COVID-19-related hospitalizations rose 24 percent in the past week.
  • The number of these patients on ventilators remained unchanged over the past week while the number in hospital intensive care units rose 14 percent.
  • The significant increase in the number of new COVID-19 cases in Pennsylvania has resulted in significant changes in the status of community transmission of the virus in the state’s 67 counties.  Currently, no counties are experiencing a low rate of community transmission and only four counties (Mifflin, Perry, Snyder, and Somerset) are experiencing a moderate rate; nine counties (Blair, Fayette, Franklin, Fulton, Greene, Huntingdon, Jefferson, Juniata, and Philadelphia) experienced a substantial rate of community transmission; and the remaining 54 counties are currently experiencing a high rate of community transmission of COVID-19.

Stakeholder Events

Department of Health – Health Research Advisory Committee – May 18

The Department of Health’s Health Research Advisory Committee will meet virtually on Wednesday, May 18 to hold a formal vote on upcoming priorities.  For information about how to participate in the meeting see this Pennsylvania Bulletin notice.

Department of Human Services – Learning Network/Nursing Facilities – May 19

DHS’s Learning Network, part of its Quality Strategy for Nursing Facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on the role that vaccinations, including influenza, pneumonia, COVID-19, and others, can play in avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, May 19 at 2:00.  For further information about the webinar and to register to participate, go here.

DHS, Department of Health, Department of Veterans Affairs – PA Cares Training Summit – May 24

Pennsylvania’s departments of Human Services, Health, and Veterans Affairs, in cooperation with the five branches of the U.S. armed forces, will hold a “PA Cares Training Summit 2022” on Tuesday, May 24 at 8:00 a.m.  The event will focus on considerations that are needed to promote wellness in the lives of service members, veterans, and their families.  The target audience is professionals in the field and includes but is not limited to community mental health and substance abuse agencies, social workers, professional counselors, nurses, psychiatrists, psychologists, clergy/pastoral or spiritual practitioners, and the staff of Pennsylvania veterans centers.  Learn more about the event, its agenda, the presenters, and how to participate from this program announcement.  Participation is limited to the first 300 people who register.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – May 25

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, May 25 at 1:00.  Go here to register to participate.

Department of Health – Statewide HIV Planning Group – May 25 and 26

The Department of Health’s Statewide HIV Planning Group will hold a public meeting in Harrisburg, on Wednesday, May 25 and Thursday, May 26 from 9:00 to 4:30 on both days.  The purpose of these meetings is to conduct an integrated prevention and care HIV planning process in which the Department of Health works in partnership with the community and stakeholders to enhance access to HIV prevention, care and treatment services.  Interested parties also may participate virtually.  For additional information, including the location of the meeting and how to join virtually, see this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – May 26

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, May 26 at 10:00.  Go here to register to participate.

DHS – Medical Advisory Committee – Managed Long-Term Services and Supports Subcommittee – June 1

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will be held virtually on Wednesday, June 1 at 10:00.  There will be an opportunity to submit questions and offer comments.  Go here to register to participate or dial in at 415-655-0052, access code 498030891#.

DHS – Office of Long-Term Living – Financial Management Services Stakeholder Meeting – June 3

DHS’s Office of Long-Term Living will hold a financial management services stakeholder meeting on Friday, June 3 at 1:00.  The purpose of this virtual meeting is to discuss upcoming changes for the administration of financial management services under the Community HealthChoices, OBRA Waiver, and Act 150 programs.  Representatives from the Office of Long-Term Living and Community HealthChoices managed care organizations will discuss upcoming changes.  Go here to register to participate.

PA Health Policy Update for the Week of May 2-6

The following is an update of selected state health policy developments in Pennsylvania for the week of May 2-6, 2022.  (Some of the language used below is taken directly from state documents.)

General Assembly

The Center for Rural Pennsylvania, a legislative agency of the state’s General Assembly, has issued a report on access to mental health services in rural Pennsylvania that identifies barriers and challenges to obtaining mental health care in rural areas and offers proposals for addressing them, including expanding and funding telehealth services.  Learn more from the report “Access to Mental Health Services in Rural Pennsylvania.”

The House Democratic Policy Committee held an informational hearing this week examining the opioid epidemic.  Find the hearing’s agenda and testimony here.

Revenue Collection Update

Pennsylvania’s General Fund revenue collections in April totaled $6.5 billion, which is $1.8 billion, or 38.7 percent, above estimate.  Fiscal year-to-date General Fund revenue collections are $4.5 billion, or 12.4 percent, above estimate.  Governor Wolf issued a press release noting that April’s revenue collection was the most ever collected by the state in a single month.

Department of Human Services

  • The Department of Human Services (DHS) has announced its intent to allocate funds in FY 2022 for several classes of inpatient disproportionate share hospital (DSH) payments and supplemental payments to Medical Assistance-enrolled, qualifying inpatient acute-care general hospitals.  Specifically, DHS intends to allocate $9.510 million in total funds for DSH payments to qualifying acute-care general hospitals that provide a high volume of services to the Medicaid population to promote continued access to inpatient and ancillary outpatient services and to support academic medical programs that provide integrated, patient-centered medical services; to allocate $5.917 million in total funds for DSH payments to qualifying acute-care general hospitals to promote the availability of professional medical services to Medicaid populations in less urbanized areas by supporting medical education and academic medical programs; and to allocate $40.163 million in total funds for supplemental payments to qualifying acute-care general hospitals that treat a high percentage of Medicaid patients under 18 years of age.  Learn more from this Pennsylvania Bulletin notice.
  • DHS has issued a Medical Assistance Bulletin to clarify its guidelines for the delivery of services via telemedicine through the Medical Assistance program’s fee-for-service delivery system.  The bulletin applies to all providers enrolled in the Medical Assistance program.  Providers rendering such services under the managed care delivery system should address coverage and payment questions for the delivery of services via telemedicine to the appropriate managed care organization.  Find the bulletin here.
  • DHS has shared presentations offered at the April 28 meeting of the Medical Assistance Advisory Committee (MAAC) by:
  • DHS has posted a draft file note of the April 14 meeting of the Medical Assistance Advisory Committee’s managed care delivery system subcommittee.

Department of Health

The Department of Health has issued a health alert updating its vaccine recommendations for hepatitis A and B.

The Department of Health has issued a health alert about failure to disinfect assisted blood glucose monitors between uses posing a risk for blood-borne pathogen transmission.  The alert describes the problem, offers suggestions for how to prevent it, and points providers to resources for further information.  Find the alert here.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed for the sixth consecutive week.  The state’s seven-day average of new cases rose eight percent, from 1734 on April 28 to 1834 on May 5.
  • The seven-day average of COVID-19-related deaths rose from nine on April 28 to 13 on May 5.
  • The growing number of COVID-19 cases in the state has led to a corresponding increase in COVID-19-related hospitalizations, with Pennsylvania experiencing a 22 percent increase in COVID-19-related hospitalizations for the second consecutive week.
  • While the number of these patients on ventilators rose 20 percent over the past week and the number in hospital ICUs rose 33 percent, the actual number of such patients remains modest in comparison to times earlier in the pandemic when the daily case counts were comparable.
  • During the past week 35 Pennsylvania counties, up from 22 last week, experienced high rates of community transmission of COVID-19; two counties, one fewer than last week, experienced a low rate of transmission; 21 counties, down from 22 last week, experienced a substantial rate of community transmission; and the remaining nine counties experienced a moderate rate.

Department of State

The Department of State has announced that the professional licensing waivers it issued under the COVID-19 disaster declaration will begin expiring in phases starting on May 23, with all waivers scheduled to expire by June 30.  Go here for a list of the department’s waivers and their expiration dates.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – May 10

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Tuesday, May 10 at 10:00.  To register to participate, go here.

Department of Human Services – Medical Assistance Advisory Committee Managed Care Delivery System Subcommittee – May 12

The managed care delivery system subcommittee of the Medical Assistance Advisory Committee will meet virtually on Thursday, May 12 at 10:00.  For an agenda for the meeting and information about how to participate, go here.

Department of Human Services – Learning Network/Nursing Facilities – May 12

DHS’s Learning Network, part of its Quality Strategy for Nursing Facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a special population webinar on avoiding hospitalizations from nursing facilities on Thursday, May 12 at 2:00.  Recommended nursing home participants are admissions coordinators, directors of nursing, and social services staff.  For more information about the webinar and how to register, go here.

Department of Human Services – Learning Network/Nursing Facilities – May 19

DHS’s Learning Network, part of its Quality Strategy for Nursing Facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on the role that vaccinations, including influenza, pneumonia, COVID-19, and others, can play in avoiding hospitalizations from nursing homes.  The webinar will be held on Thursday, May 19 at 2:00.  For further information about the webinar and to register to participate, go here.

DHS – Office of Medical Assistance Programs – Gun Violence Roundtable – date in May to be determined 

DHS’s Office of Medical Assistance Programs will convene a roundtable in May to discuss gun violence as a public health issue and to explore public health strategies that can be used by Medicaid managed care organizations to prevent and respond to gun violence.  A save-the-date will be sent out in the next week or so and the managed care organizations will be given a list of questions to come prepared to discuss.  An opportunity to present on current and planned initiatives, as well as challenges and limitations, will be offered to each managed care organization.

 

PA Health Policy Update for the Week of April 18-22

The following is an update of selected state health policy developments in Pennsylvania for the week of April 18-22, 2022.  (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has signed House Bill 245, which reduces the graduate medical training required for international medical graduates from three years to two years; removes the limit on the number of affiliated facilities at which a doctor with an institutional license may practice or teach; and expands and clarifies the scope of practice of temporarily licensed physicians.

General Assembly

  • The state House will be in session next Monday (4/25), Tuesday (4/26), and Wednesday (4/27). The Senate is in recess.
  • The House Professional Licensure Committee will meet on Monday, April 25 at 10:00 a.m. to consider House Bill 1956, which creates a license for certified anesthesiologist assistants.
  • The House Health Committee will convene on Tuesday, April 26 at 9:30 a.m. to consider the following bills.
    • House Bill 398, which requires a non-custodial parent of a child to enroll their child in their own health insurance plan before seeking Medicaid coverage.
    • House Bill 2441, which gives legislative agencies access to records information for research purposes under the Vital Statistics Law.
    • Senate Bill 317, which provides for the authority to prescribe antibiotics to treat sexually transmitted infections without having examined the individual for whom the drug is intended, in accordance with the Expedited Partner Therapy in the Management of Sexually Transmitted Diseases guidance issued by the CDC.
    • Senate Bill 818, which seeks to align procedures permitted in licensed ambulatory surgery centers with those of the federal Centers for Medicare & Medicaid Services (CMS).

Department of Human Services

  • Act 2 of 2022 appropriated $225 million to support the health care workforce needs of hospitals and behavioral health providers.  The law directed that the funding be used strictly for recruitment and retention payments to direct care staff.  Entities receiving payments under Act 2 must submit a report to the Department of Human Services (DHS) documenting staff retention payments by September 30, 2022 and a report on staff recruitment spending by December 31, 2022.  DHS has posted an FAQ describing how Act 2 works and has added to that FAQ a template for submitting the required reports.  Find the FAQ and the report template here.
  • DHS has updated its calendar for delivering Remittance Advice and corresponding checks to extend into early June.
  • DHS has issued a Medical Assistance Bulletin to announce the addition of new procedure codes to the Medical Assistance program fee schedule for the provision of personal care services that are provided through home health agencies to Medicaid beneficiaries under 21 years of age.  Find that bulletin here.
  • DHS has posted a notice to Medical Assistance fee-for-service providers reminding them of the recommended documentation needed to support the review of authorization requests for private duty/shift nursing and home health aide service hours provided to children under the age of 21.  Find that notice here.
  • DHS has shared the minutes of the February 23 meeting of the Medical Assistance Advisory Committee’s consumer subcommittee.
  • DHS has updated its “Monthly Physical Health Managed Care Program Enrollment Report” to include March 2022 data.

Department of Health

  • Keara Klinepeter has resigned as Pennsylvania’s Acting Health Secretary.  She will be replaced by the state’s Physician General, Dr. Denise Johnson.  Learn more from this Wolf administration news release.
  • The Secretary of Health issued a letter to the hospital community clarifying that the intention of the recently issued innovative hospital guidance was to preserve access to care in rural communities in a financially sustainable way.  Find a copy of that letter here.
  • The Department of Health has updated its guidance to providers caring for adults and children with multisystem inflammatory syndrome.
  • The Department of Health has updated its information about state-sponsored free COVID-19 testing sites to reflect that it currently operates such sites in Berks, Blair, Centre, and Clinton counties and at Edinboro University in Erie.  Learn more about the locations and hours of operation in this department news release.

COVID-19:  By the Numbers

  • Daily COVID-19 case counts climbed for the fourth consecutive week.  The state’s seven-day average of new cases rose 26 percent, from 1067 cases on April 14 to 1343 on April 21.
  • The seven-day average of COVID-19-related deaths, which has long been declining, rose during the past week from 10 on April 13 to 16 to April 21.
  • The rising number of COVID-19 cases in Pennsylvania has led to increases in some but not all measures of COVID-19-related hospital care.  In the past week the number of Pennsylvanians hospitalized with the virus rose 13 percent and has now risen 21 percent since the beginning of the month.  The number of COVID-19 patients in hospital ICUs rose 15 percent in the past week but remains modest.  The number of such patients being treated on ventilators, on the other hand, declined 22 percent and remains very low.
  • During the past week nine Pennsylvania counties, up from five last week, experienced high rates of community transmission of COVID-19; three counties, down from five last week, experienced a low rate of transmission; 20 counties, up from 15 last week, experienced a substantial rate of community transmission; and the remaining 35 counties experienced a moderate rate.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released a fourth quarter 2021 report on the effect of COVID-19 on hospitals and health care facilities in Pennsylvania.  In the report, PHC4 aggregates data on fourth quarter of 2021 COVID-19 expenses and lost revenue as reported by hospitals and health systems to show the impact of the public health emergency on those institutions.  The data in the report reflects financial performance for fewer than half of the hospitals in the state and does not include emergency funding the providers received from the federal or state government.  Learn more from this PHC4 news release and the agency’s “COVID-19 Disaster Emergency Report.”

Stakeholder Events

Behavioral Health Services for the Nursing Facility Population – April 26 and May 3

The Department of Human Services’ Office of Long-Term Living, Office of Mental Health and Substance Abuse Services (OMHSAS), the HealthChoices behavioral health managed care organizations, and the Community HealthChoices managed care organizations will host a joint webinar on the importance of providing behavioral health services in nursing facilities and making sure nursing facilities know how to gain access to these services.  The webinar will be held two more times and the material presented will be the same at each session.  The webinars will be recorded.  The session on Tuesday, April 26 will be held at 2:00; go here for more information and to register to participate.  The session on Tuesday, May 3 also will be held at 2:00; go here for more information and to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – April 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, April 27 at 1:00.  Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – April 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, April 28 at 10:00.  Go here to register to participate.

Special Pharmaceutical Benefits Program Advisory Council – April 28

The Department of Human Services’ Special Pharmaceutical Benefits Program Advisory Council will meet by teleconference on Thursday, April 28 at 10:00.  Join the meeting at 866-588-4789 and use conference ID code 211 418 005#.

Patient Safety Authority – April 28

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, April 28 at 1:00 p.m.  For information about how to participate see this Pennsylvania Bulletin notice.

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